|
HC ENDO STENT PLACEMENT
|
Facility
|
IP
|
$804.23
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$506.66 |
| Max. Negotiated Rate |
$723.81 |
| Rate for Payer: Aetna Commercial |
$683.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.75
|
| Rate for Payer: Cash Price |
$643.38
|
| Rate for Payer: Cofinity Advantage |
$562.96
|
| Rate for Payer: Cofinity Commercial |
$691.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$643.38
|
| Rate for Payer: Healthscope Commercial |
$723.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$683.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.17
|
| Rate for Payer: PHP Commercial |
$683.60
|
| Rate for Payer: Priority Health SBD |
$506.66
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
IP
|
$3,056.70
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,925.72 |
| Max. Negotiated Rate |
$2,751.03 |
| Rate for Payer: Aetna Commercial |
$2,598.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,986.86
|
| Rate for Payer: Cash Price |
$2,445.36
|
| Rate for Payer: Cofinity Advantage |
$2,139.69
|
| Rate for Payer: Cofinity Commercial |
$2,628.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,445.36
|
| Rate for Payer: Healthscope Commercial |
$2,751.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,598.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.53
|
| Rate for Payer: PHP Commercial |
$2,598.20
|
| Rate for Payer: Priority Health SBD |
$1,925.72
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
OP
|
$3,056.70
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$818.27 |
| Max. Negotiated Rate |
$2,751.03 |
| Rate for Payer: Aetna Commercial |
$2,598.20
|
| Rate for Payer: Aetna Medicare |
$1,528.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,986.86
|
| Rate for Payer: BCBS Complete |
$1,222.68
|
| Rate for Payer: BCBS Trust/PPO |
$818.27
|
| Rate for Payer: BCN Commercial |
$818.27
|
| Rate for Payer: Cash Price |
$2,445.36
|
| Rate for Payer: Cash Price |
$2,445.36
|
| Rate for Payer: Cofinity Advantage |
$2,139.69
|
| Rate for Payer: Cofinity Commercial |
$2,628.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,445.36
|
| Rate for Payer: Healthscope Commercial |
$2,751.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,445.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,598.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.53
|
| Rate for Payer: PHP Commercial |
$2,598.20
|
| Rate for Payer: Priority Health SBD |
$1,925.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,986.86
|
| Rate for Payer: UHC Core |
$1,592.54
|
| Rate for Payer: UHC Exchange |
$1,201.28
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
OP
|
$4,160.46
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$3,536.39
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,704.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cofinity Advantage |
$2,912.32
|
| Rate for Payer: Cofinity Commercial |
$3,578.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,744.41
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,536.39
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,120.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,536.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,621.09
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
IP
|
$4,160.46
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,621.09 |
| Max. Negotiated Rate |
$3,744.41 |
| Rate for Payer: Aetna Commercial |
$3,536.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,704.30
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cofinity Advantage |
$2,912.32
|
| Rate for Payer: Cofinity Commercial |
$3,578.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.37
|
| Rate for Payer: Healthscope Commercial |
$3,744.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,536.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,120.34
|
| Rate for Payer: PHP Commercial |
$3,536.39
|
| Rate for Payer: Priority Health SBD |
$2,621.09
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
OP
|
$266.76
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$106.70 |
| Max. Negotiated Rate |
$240.08 |
| Rate for Payer: Aetna Commercial |
$226.75
|
| Rate for Payer: Aetna Medicare |
$133.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.39
|
| Rate for Payer: BCBS Complete |
$106.70
|
| Rate for Payer: Cash Price |
$213.41
|
| Rate for Payer: Cofinity Advantage |
$186.73
|
| Rate for Payer: Cofinity Commercial |
$229.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.41
|
| Rate for Payer: Healthscope Commercial |
$240.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.07
|
| Rate for Payer: PHP Commercial |
$226.75
|
| Rate for Payer: Priority Health SBD |
$168.06
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
IP
|
$266.76
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$168.06 |
| Max. Negotiated Rate |
$240.08 |
| Rate for Payer: Aetna Commercial |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.39
|
| Rate for Payer: Cash Price |
$213.41
|
| Rate for Payer: Cofinity Advantage |
$186.73
|
| Rate for Payer: Cofinity Commercial |
$229.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.41
|
| Rate for Payer: Healthscope Commercial |
$240.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.07
|
| Rate for Payer: PHP Commercial |
$226.75
|
| Rate for Payer: Priority Health SBD |
$168.06
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
OP
|
$4,204.81
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$3,574.09
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,733.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,905.68
|
| Rate for Payer: BCN Commercial |
$1,905.68
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cofinity Advantage |
$2,943.37
|
| Rate for Payer: Cofinity Commercial |
$3,616.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,363.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,784.33
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,574.09
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,153.61
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,574.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,649.03
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,733.13
|
| Rate for Payer: UHC Core |
$2,190.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,652.49
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
IP
|
$4,204.81
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,649.03 |
| Max. Negotiated Rate |
$3,784.33 |
| Rate for Payer: Aetna Commercial |
$3,574.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,733.13
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cofinity Advantage |
$2,943.37
|
| Rate for Payer: Cofinity Commercial |
$3,616.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,363.85
|
| Rate for Payer: Healthscope Commercial |
$3,784.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,574.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,153.61
|
| Rate for Payer: PHP Commercial |
$3,574.09
|
| Rate for Payer: Priority Health SBD |
$2,649.03
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,901.65
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,926.35 |
| Max. Negotiated Rate |
$4,411.48 |
| Rate for Payer: Aetna Commercial |
$4,166.40
|
| Rate for Payer: Aetna Medicare |
$2,450.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,186.07
|
| Rate for Payer: BCBS Complete |
$1,960.66
|
| Rate for Payer: Cash Price |
$3,921.32
|
| Rate for Payer: Cofinity Advantage |
$3,431.16
|
| Rate for Payer: Cofinity Commercial |
$4,215.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,921.32
|
| Rate for Payer: Healthscope Commercial |
$4,411.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,921.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,166.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,676.24
|
| Rate for Payer: PHP Commercial |
$4,166.40
|
| Rate for Payer: Priority Health SBD |
$3,088.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,186.07
|
| Rate for Payer: UHC Core |
$2,553.76
|
| Rate for Payer: UHC Exchange |
$1,926.35
|
|
|
HC ENDOVENT
|
Facility
|
IP
|
$4,901.65
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,088.04 |
| Max. Negotiated Rate |
$4,411.48 |
| Rate for Payer: Aetna Commercial |
$4,166.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,186.07
|
| Rate for Payer: Cash Price |
$3,921.32
|
| Rate for Payer: Cofinity Advantage |
$3,431.16
|
| Rate for Payer: Cofinity Commercial |
$4,215.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,921.32
|
| Rate for Payer: Healthscope Commercial |
$4,411.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,166.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,676.24
|
| Rate for Payer: PHP Commercial |
$4,166.40
|
| Rate for Payer: Priority Health SBD |
$3,088.04
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,897.16
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,085.21 |
| Max. Negotiated Rate |
$4,407.44 |
| Rate for Payer: Aetna Commercial |
$4,162.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,183.15
|
| Rate for Payer: Cash Price |
$3,917.73
|
| Rate for Payer: Cofinity Advantage |
$3,428.01
|
| Rate for Payer: Cofinity Commercial |
$4,211.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,917.73
|
| Rate for Payer: Healthscope Commercial |
$4,407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,162.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.87
|
| Rate for Payer: PHP Commercial |
$4,162.59
|
| Rate for Payer: Priority Health SBD |
$3,085.21
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
OP
|
$4,897.16
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,924.58 |
| Max. Negotiated Rate |
$4,407.44 |
| Rate for Payer: Aetna Commercial |
$4,162.59
|
| Rate for Payer: Aetna Medicare |
$2,448.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,183.15
|
| Rate for Payer: BCBS Complete |
$1,958.86
|
| Rate for Payer: Cash Price |
$3,917.73
|
| Rate for Payer: Cofinity Advantage |
$3,428.01
|
| Rate for Payer: Cofinity Commercial |
$4,211.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,917.73
|
| Rate for Payer: Healthscope Commercial |
$4,407.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,917.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,162.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.87
|
| Rate for Payer: PHP Commercial |
$4,162.59
|
| Rate for Payer: Priority Health SBD |
$3,085.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,183.15
|
| Rate for Payer: UHC Core |
$2,551.42
|
| Rate for Payer: UHC Exchange |
$1,924.58
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
|
|
HC ENTEROVIRUS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$249.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$224.73 |
| Rate for Payer: Aetna Commercial |
$212.25
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cofinity Advantage |
$174.79
|
| Rate for Payer: Cofinity Commercial |
$214.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$224.73
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.25
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.28
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$212.25
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$157.31
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$249.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$157.31 |
| Max. Negotiated Rate |
$224.73 |
| Rate for Payer: Aetna Commercial |
$212.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.31
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cofinity Advantage |
$174.79
|
| Rate for Payer: Cofinity Commercial |
$214.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.76
|
| Rate for Payer: Healthscope Commercial |
$224.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.28
|
| Rate for Payer: PHP Commercial |
$212.25
|
| Rate for Payer: Priority Health SBD |
$157.31
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$209.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$132.20 |
| Max. Negotiated Rate |
$188.86 |
| Rate for Payer: Aetna Commercial |
$178.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.40
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cofinity Advantage |
$146.89
|
| Rate for Payer: Cofinity Commercial |
$180.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.87
|
| Rate for Payer: Healthscope Commercial |
$188.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.38
|
| Rate for Payer: PHP Commercial |
$178.36
|
| Rate for Payer: Priority Health SBD |
$132.20
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$209.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$188.86 |
| Rate for Payer: Aetna Commercial |
$178.36
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cofinity Advantage |
$146.89
|
| Rate for Payer: Cofinity Commercial |
$180.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$188.86
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.36
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.38
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$178.36
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$132.20
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.52 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health SBD |
$63.52
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$38.31
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$4.73
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$9.20
|
| Rate for Payer: BCN Commercial |
$9.20
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Mclaren Medicaid |
$4.51
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Medicaid |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.62
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health SBD |
$24.14
|
| Rate for Payer: Priority Health Tiered Network |
$6.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.93
|
| Rate for Payer: UHC Core |
$12.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.62
|
| Rate for Payer: UHC Exchange |
$12.93
|
| Rate for Payer: UHC Medicaid |
$4.51
|
| Rate for Payer: UHCCP Medicaid |
$4.51
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$38.31
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: Priority Health SBD |
$24.14
|
|
